Preemptive Analgesia in Recovery from Hysterectomy

University Of Pennsylvania, Philadelphia PA

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Abstract

DESCRIPTION (provided by applicant): Over half of the over 23 million surgical procedures are accompanied by inadequately treated pain. Pain interferes with bodily functions such as breathing, blood pressure regulation, digestion etc. It inhibits the patient s ability to participate in postoperative care regimens, and clearly increases the risk of postoperative respiratory complications. After discharge, the poorly controlled pain continues to plague patients. The pain associated with surgery can lead to chronic pain syndromes due to sensitization of the central nervous system (CNS). We have chosen to use trans-abdominal hysterectomy (TAH) as a model operation because 600,000 women a year have hysterectomies, and women are more prone to suffering chronic painful syndromes. Preemptive analgesia is an intervention designed to decrease pain and improve patient recovery from surgery by initiating an analgesic regimen prior to the onset of the painful stimuli. There is clear animal based research and a growing body of human clinical research that preemptive analgesia can reduce pain and analgesic needs following surgery. Recent work has extended the proof of benefits in the form of decreased pain and increased activity to well after discharge from the hospital. This research application proposes to examine the short- and long-term benefits of aggressive preemptive epidural analgesia in patients undergoing TAR Pain during hospitalization and after discharge, activity levels, and return to preoperative function will be quantitatively assessed with validated outcome measures. Dr. Ochroch, an Assistant Professor of Anesthesiology at the University of Pennsylvania, is applying for a Clinical Investigator Award (K23) to pursue an academic career focusing on improving recovery from surgery. He has a serious interest in this area as evidenced by his involvement in current and proposed research. This application requests support to allow him to undertake a comprehensive career development program including: 1) a Masters in Biostatistics and Epidemiology under the mentorship of Dr. Brian Strom, 2) a research preceptor ship with Drs. John Farrar and Allan Gottschalk and Mark Morgan, and 3) the proposed research project. These activities will provide him with the skills and experience to pursue a successful career of meaningful funded research as an independent investigator.